Central Sensitization in Vulvodynia and Endometriosis: What Have We Been Overlooking So Far?

Cetera GE, Giulia Emily Cetera, Merli CEM, Camilla Erminia Maria Merli, Boero V, Veronica Boero, Caia C, Carlotta Caia, Federica Facchin, Facchin F, Giussy Barbara, Giussy Barbàra, Barbara G, Monti E, Ermelinda Monti, Paolo Vercellini
Obstetrical & gynecological survey · 2023 · vol. 78(12) , pp. 745–758 · doi:10.1097/ogx.0000000000001183 · PMID:38134340 · W4389778786
review OA: green CC0 ⤵ 8 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review collected evidence suggesting central sensitization plays a role in vulvodynia and endometriosis, noting altered serum markers, brain networks, reduced pain thresholds, and self-reported pain components.

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Abstract

IMPORTANCE: Women experience more frequent and greater pain than men, although they receive less adequate treatment and are perceived as more anxious than males. Recent clinical research has lead to hypothesize a common etiology for overlapping chronic pain conditions and mood disorders, namely, central sensitization, which originates from an alteration of pain processing pathways in the central nervous system. OBJECTIVE: The aim of this review was to collect all available evidence regarding the potential role of central sensitization in vulvodynia and endometriosis. EVIDENCE ACQUISITION: A systematic literature search was performed between July and August 2022 using the electronic database PubMed. The extracted data were summarized using a narrative approach. RESULTS: Ten articles were chosen for the review. Participants' mean age was 39.2 years (SD = 5.1). Among serum markers of central sensitization, nitric oxide levels were greater in women with endometriosis than in controls, whereas brain-derived neurotrophic factor and S100B levels differed among pain conditions with structural anomalies and those without. Functional magnetic resonance imaging showed different resting state networks between patients with endometriosis and controls. In neurophysiology studies, cases had reduced pain thresholds, compared with healthy controls. Lastly, self-reported questionnaires suggested a central component of pain in women with endometriosis-related dyspareunia and associated bladder/pelvic floor tenderness. CONCLUSIONS AND RELEVANCE: The management of vulvodynia and endometriosis may benefit from a new perspective, which considers their possible central etiology. It is compelling that treatment of pain starts to be considered a therapeutic goal in its own right.

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Condition tags

endometriosischronic_pelvic_paindyspareunia

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (27)

Cited by (9)

Source provenance

europepmc
last seen: 2026-07-29T06:27:48.050232+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-07-29T06:26:07.019607+00:00
License: CC0 · commercial use OK